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Sunday, February 04, 2007

Nouthetic counseling

Last Sunday a guest speaker at church did a little promo for an upcoming seminar on nouthetic counseling. Since this movement has a following in some Reformed circles, I’ll take the occasion to briefly evaluate nouthetic counseling.

I. Preliminaries

Nouthetic counseling was founded by Jay Adams. Adams is even better known as a world-class skateboarder.

On second thought, that’s a different Jay Adams. Sorry ‘bout that!

Moving along—as soon as you slap a “Reformed” adjective ontp something or another, a number of people in the Reformed community let down their guard. “Well, if it’s ‘Reformed,’ then it must be good!”

But we need to observe a few cautions:

1.The fact that a Calvinist may believe in something doesn’t automatically make his belief a Reformed distinctive or Reformed essential. Let’s not confuse an adventitious association with a logical implication.

For example, Harold Camping made a name for himself as a Calvinist. But this doesn’t, by any stretch of the imagination, mean that some of his eccentric beliefs are the least bit Calvinistic.

2.Even if something is Reformed, there can sometimes be more than one Reformed viewpoint.

3.And even if something is Reformed, it still needs to acquit itself before the bar of Scripture.

I don’t say any of this in criticism of nouthetic counseling. But just as a reminder that not everything which flies under the banner of Calvinism should go unexamined.

II. The Upside

1.There’s no doubt that modern psychology is chock-full of quackery and irreligious ideology. Indeed, the two often go together. Irreligious ideology promotes quackery, while quacks promote irreligious ideology.

Nouthetic counseling has rightly summed us to be alert to the humanism and charlatanism embedded in so much modern psychology.

2.Apropos (1), it’s often impossible to give sound advice without a sound view of human nature or morality. This Bible is the first place we should turn for such guidance.

Once again, nouthetic counseling has rightly redirected the conversation.

3.Adams has accentuated the importance of behavior modification. Not merely the attempt to break off bad habits, but forming good habits to take the place of bad habits. Up to a point, this is useful advice.

4.Although Adams is best known for nouthetic counseling, he has also written a number of very useful books on preaching. Indeed, I regard his writing in the field of homiletics as preferable to his psychological stuff.

5.Adams has the voice, vernacular, and stage-presence of a natural-born preacher. Some of his taped sermons are good models of manly preaching.

III. The Downside

Adams is a reactionary. As such, he’s distinguished by the strengths and weaknesses of a reactionary.

1.Certainly we should look to the Bible as our primary source of guidance. When, however, we look to the Bible, we also find that the Bible points us to the real world as another source of knowledge.

To the extent that modern psychology can never entirely escape natural revelation or common grace, there is much to be gleaned from a discriminating study of modern psychology.

There’s an anti-scientific bias to nouthetic counseling, but Calvinism has a doctrine of ordinary providence.

2.Apropos (1), we can also learn a thing or two from Christian practioners outside the Reformed stable, such as Paul C. Vitz, Gary Collins, Paul Meier, Norman Wright, and James Dobson.

3.Nouthetic counseling has a problem with mental illness. Ironically, Adams is also influenced by academic fads and secular authors. As Martyn Lloyd-Jones, a fellow Calvinist, has pointed out:

***QUOTE***

The third category [of illness] to which your patient, or enquirer, may belong is the psychological. I use that general term, but if you prefer it, it could be “mental illness.” This is at the present time an important consideration because we are now in the midst of one of the latest crazes, or fashions, in the Christian, and even evangelical, world. The concept of “mental illness” has come under attack at the present time, mainly as the result of the writings of Thomas Szasz…Unfortunately, too, he now has a number of followers who are writing up his views in popular books. One of the best known is Jay Adams with his widely selling Competent to Counsel. But he is just a popularizer of Thomas Szasz and he is simply affirming, with Szasz, that there is no such entity as mental illness, that patients are really suffering from sin and need to be dealt with purely in a scriptural manner,” Healing & the Scriptures (T. Nelson 1988), 153,155.

***END-QUOTE***

4.Apropos (3), the proudly amateurish quality of nouthetic counseling would potentially endanger a counselee who suffers from mental illness.

For example, nouthetic counseling doesn’t have much use for psychotropic drugs. Indeed, a nouthetic counselor, unlike a psychiatrist, lacks the medical training or certification to administer psychotropic drugs.

Now there’s no doubt that we live in an overmedicated culture. But this doesn’t mean that mental illness is an illusion, or that mental illness can never be treated by psychotropic drugs.

5.Because nouthetic counseling is theologically oriented, it is only as good as the theology feeding into it.

For example, on matters of divorce and remarriage, it is only as good as its exegesis of the pertinent passages of Scripture. And, in that respect, there’s no particular reason why we should first turn to Jay Adams or some disciple of his for the exegesis of Gen 2 or Mt 19 or 1 Cor 7. Begin with the leading commentators.

In my opinion, Adams is not a terribly discerning or reliable exegete.

6.Likewise, Adams is a cessationist. And since nouthetic counseling is theologically-oriented, this has a direct impact on a certain type of counselee.

Adams doesn’t believe in demonic possession during the church age, or other forms of occultic bondage.

But if he’s wrong on that, then nouthetic counseling will be ineffectual at best, and harmful at worst, in dealing with a counselee who is suffering from some form of demonic oppression.

7.Adams has a rather mechanical, push-bottom approach to sanctification, as if by running down a checklist you can outgrow a besetting sin or compulsive behavior.

But our sins and character-traits are often far more entrenched than that lawnmower will successfully uproot.

8.Apropos (7), nouthetic counseling fosters a cookie-cutter attitude towards the counselee. You don’t really listen to them. Or you only listen long enough to locate them in a preexisting slot, then quote Scripture to them.

In my opinion, a number of the Puritans, like William Ames, Richard Sibbes, and Richard Baxter were far better at dealing with cases of conscience than the fairly formulaic and confrontational methods of nouthetic counseling, viz.

14 comments:

Wow, I have worked and studied with Dr. Adams for years and the misrepresentation of Adams' views personally and nouthetic counseling as a movement here is breathtaking. I would gently urge the reader of this blog to read Adams for yourself and not draw conclusions about nouthetic counseling from the straw man built here.

Normally I am in considerable agreement with you (I don't think we've crossed swords even once), but this latest installment seems to suffer from a few weaknesses.

To begin with, it fails to distinguish between psychology as a descriptive discipline and psychology as a prescriptive discipline. Your piece seems to suggest that nouthetic counselors cavalierly dismiss psychology wholesale.

As I understand it, many in NANC do not take issue with the descriptive function of psychological studies (which can be interesting and even helpful). Rather, their significant complaint is with the attempt of psychologists to undertake the prescriptive task (and this debate is complex and has been treated by various authors in published literature – if you’re going to address it, I’d suggest engaging that literature as a starting point).

is an overly broad generalization. Not a few nouthetic counselors are indeed Medical Doctors (in fact, Bob Smith, whom you cited by link in your response to Donn Arms is an M.D. who has published a Medical Desk Reference for Nouthetic Counelors ).

Further, every year at the NANC annual conference there is a pre-conference for medical professionals (M.D.'s and other health professionals) - so the "proudly amateurish quality" characterization leveled against nouthetic counseling may be premature.

Moreover, psychologists can't prescribe drugs either - so we should probably distinguish between Psychiatrists and Psychologists. Are we dealing with psychology or psychiatry? Your piece seemed to equivocate between the two if I read you correctly.

Perhaps even more to the point is that the very propriety of psychotropic drugs seems to have been merely taken for granted in this piece. I didn't see any interaction with specific claims and/or arguments of published nouthetic authors on this topic (e.g., Blame it on the Brain?, by Ed Welch or Bob Smith's Medical Desk Reference). It’s fine, of course, to believe in their propriety, but an argument or two would probably bolster the persuasiveness of your stated beliefs (as would a medical credential or citations by credentialed medical professionals to counter those appealed to by nouthetic counselors).

Regrettably, I concur with Donn Arms' suggestion that someone interested in learning more about nouthetic counseling should probably go study this issue in more depth elsewhere.

Maybe because I can find such cavalier, wholesale dismissals in the nouthetic literature itself, such as:

"Look once again at your qualifications for the work. What training, for instance, is really best for the task of changing men's lives? Medical training? Psychiatric training? Training in some clinic or theoretical school of psychotherapy in New York or Washington? University training in psychology? What about a solid seminary training in the Word of God?"

"Not a few nouthetic counselors are indeed Medical Doctors (in fact, Bob Smith, whom you cited by link in your response to Donn Arms is an M.D. who has published a Medical Desk Reference for Nouthetic Counelors )."

i) True, but that's beside the point since medical training is not a prerequisite for certification as a nouthetic counselor:

https://www.nanc.org/page.asp?contentid=28&sub=2

ii) One would also like to know the field of medical specialization, if any, since that is relevant to the diagnosis.

"Further, every year at the NANC annual conference there is a pre-conference for medical professionals (M.D.'s and other health professionals) - so the 'proudly amateurish quality' characterization leveled against nouthetic counseling may be premature."

Reread the first quote (see above).

"Moreover, psychologists can't prescribe drugs either - so we should probably distinguish between Psychiatrists and Psychologists. Are we dealing with psychology or psychiatry? Your piece seemed to equivocate between the two if I read you correctly."

Nouthetic counseling is openly hostile to psychiatry. For example:

"The new sort of Mental Illness, naturally, required a new sort of practitioner. Consequently, the profession of psychiatry was developed to work with these supposedly non-organically "sick" persons. In order to chalk out an area for his newly-spawned discipline, the psychiatrist moved into territory that once was inhabited by Christian ministers and by physicians…To put it another way, I find it necessary to question seriously whether there is any legitimate place for the psychiatrist."

"Perhaps even more to the point is that the very propriety of psychotropic drugs seems to have been merely taken for granted in this piece. I didn't see any interaction with specific claims and/or arguments of published nouthetic authors on this topic (e.g., Blame it on the Brain?, by Ed Welch or Bob Smith's Medical Desk Reference). It’s fine, of course, to believe in their propriety, but an argument or two would probably bolster the persuasiveness of your stated beliefs (as would a medical credential or citations by credentialed medical professionals to counter those appealed to by nouthetic counselors)."

Sorry, but that misses the point. This is, indeed, a debatable issue. But that debate should be left to the medical professionals. A guy with nothing more than a seminary degree and certificate in nouthetic counseling is hardly qualified to evaluate the scientific value, if any, of psychotropic drugs.

I keep running across claims like this in the nouthetic literature:

"There is a much smaller umbrella that legitimately might be labeled mental illness; but it is very small, almost minute, in comparison to the Freudian umbrella."

How is a mere pastor qualified to judge this claim, either for its general veracity or for any case in particular?

Likewise:

"You can send the counselee on a futile chase for some alleged relief or for the best physician in the world to treat his condition. The counselee can waste huge sums of time and money in the process. Don’t turn your counselee from the biblical response to his illness to an attempt to make certain the physician has not overlooked any diagnosis for which there might be a cure."

By the way, in case anyone is looking for the MLJ book, I did a little digging around and discovered that it's been published under three different titles -- Healing and Medicine, Healing and the Scriptures, and The Doctor Himself and the Human Condition (see this review, for instance). All three titles are also currently out of print. Fortunately, however, it is available for free online.

Dr. Adams does, it seems, have any overlyh slavish focus on medicalization, perhaps as a necessary disclaimer. However, soul care for problems-in-living is not the particular province of medicalist tradespersons. Prof. Thomas Szasz, anyone ?

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I have personally received immense benefit from nouthetic counseling (including the restoration of my marriage after a 2+ year hostile separation). So, you might call me biased. I have little doubt that a psychologist would have labeled me with some unhelpful tag and then treated me like I was the center of the universe, which would have only deepened my troubles. Nouthetic counselors, on the other hand, called me to Christ and admonished me to repent. For that, I am eternally grateful.

Are Nouthetic counselors reactionary? Some are. Does everyone agree with Jay Adams' theology? Not always. Have mistakes been made? Certainly. Adams himself would admit to the weaknesses he brought to the nouthetic movement.

What you've apparently missed, though, is the fact that the nouthetic counseling movement has grown considerably in recent years, and many important balances have been introduced. Read the works of men like Ed Welch, Paul Tripp, and others. You may find that your criticisms have already been dealt with by the second generation nouthetic teachers. In fact, you may find they have identified and brought correction to some of the very issues you raise here.

Wouldn't you agree that we're better off starting with a Biblically grounded (though flawed) viewpoint, and working from there toward balance and correction, than to start with atheistic philosophies and try to "make" them more Biblical?

I have been on both sides of the issue--that is, I read Jay Adams' original book AND I am a psychiatric professional. I can see some of the defensiveness of those who have been helped by nouthetic counseling. We are not unhappy with that. What we do find disturbing is the assumption (in one of the posts immediately prior to this one) that "I have little doubt that a [secular] psychologist would have .... " Isn't that doing to the secular psychology field exactly what Steve is being accused of doing?

I know that I'm a bit late to the table for this post but I'd like to say thanks for it anyway. There is such a great need for an ongoing discussion about the place of Biblical truth in the world of therapy.

It seems to me that the ways in which the nouthetic tribe are attempting to use the Bible is sometimes akin to labeling Poe’s The Raven as a treatise on ornithology. It misses the point entirely.

I recently wrote a comparison of two college-level classes one and intro to psych class from MIT the other a Pastoral Counseling class from Reformed Theological Seminary which is far too long to post here. The comparison and contrast is as fascinating as it is alarming.

Theologically speaking, does the nouthetic counselor ever apply the Gospel (proclaiming Christ and him crucified for the forgiveness of sins) or does he just tell you what you must DO? (e.g. law)

A depressed person would wither under such treatment without generous helpings of grace and gospel. I would hate to see this coupled with pulling out necessary medications because the counselor believes it unbiblical, especially in a person who is suicidal.

As I have read many Jay Adams books and also books of Meier, Cloud and others. Jay Adams never criticizes somebody with a real medical problem, or a hormonal and or chemical imbalance, but gets to the heart of our sinful human nature when these other diseases have been medically ruled out. The Word of God is alive and is more powerful than any two edged sword and does reveal our true heart and motives. Truly that is when we are set free.